This project is a longitudinal study of blood pressure and blood pressure correlates in a population of 1140 young adults, first seen in 1973 as adolescents aged 14-19 years. Follow-up studies in this population have focused on factors associated with blood pressure levels and other cardiovascular disease (CVD) risk factors and changes in these risk factors over time. The long term goal of this project is to relate CVD risk factors in adulthood to predisposing factors during childhood. Specific aims of the project include (1) to describe the distribution of physiologic, psychosocial and behavioral risk factors for cardiovascular disease in the population; (2) to describe age related trends in CVD risk factors over time and to identify factors associated with these trends; (3) to determine correlates of elevated blood pressure; (4) to identify cardiac consequences of high blood pressure. Subjects will be seen at home and subsequently in a clinic setting. Standardized measurements of blood pressure, height, and weight will be obtained. Information will be obtained on socioeconomic variables, pertinent medical and family histories, smoking behavior, and knowledge and beliefs regarding cardiovascular disease. Questionnaires will be administered on exercise habits, life events, hostility expression, coronary-prone behavior pattern, and anxiety. Fasting blood specimen will be obtained for serum glucose, cholesterol (HDL, LDL), triglycerides, and uric acid. To determine whether subjects with sustained high blood pressure exhibit alterations in blood flow, studies of blood flow in the macro- and microcirculation will be undertaken in selected subjects at high, intermediate, and low levels of blood pressures. Previous echocardiographic studies have suggested that subjects with sustained high blood pressures experience a significantly greater degree of systolic wall stress compared to subjects with lower blood pressures suggesting that increased wall stress, rather than hypertrophy, is the initial cardiac manifestation of elevated pressure. Repeat echocardiographic studies will permit longitudinal evaluation of left ventricular size and performance in relation to blood pressure level and in relation to high blood pressure. Analyses will include determinations of whether previously observed clustering of CVD risk factors in individuals is maintained over time, the effect of relative weight status and changes in relative weight status on other CVD risk factors, and whether adolescents initially found to have relatively high blood pressure develop sustained hypertension.